Examiner and child contributions to therapy

Abstract

The purpose of this research was to analyze child and clinician factors affecting language therapy outcomes and to analyze the potential bi-directional relationship between child and clinician factors. Transcripts of intervention sessions with one child and one trained examiner were coded for factors relating to children's language ability, examiners' strategies for reaching session targets, and differences in examiners' interactional styles. Differences in children's language ability and examiners' interactional styles did not have a strong relationship with therapy outcomes. Differences were observed in the overall frequency of examiners' strategy use across children;however, examiners were not sensitive to individual children's responsiveness to particular strategies. This is a secondary data analysis on an intervention study, which affects interpretation of the results: variability in examiner and child behaviors was decreased due to adherence to intervention protocol. However, the mismatch between examiner strategies and child responses is of interest. Making clinicians explicitly aware of the many types of elicitation and response strategies available may increase examiners' effectiveness, efficiency, or responsiveness.iii PUBLIC ABSTRACTWhy is language therapy more effective for some children than for others? What are the variables that contribute most to differences in children's progress? What interactions occur between children and therapists within the therapy process?The purpose of this study is to analyze child and therapist contributions to the progress made by children in language therapy. This study uses transcripts of therapy sessions from an ongoing language intervention study. Transcripts from sessions with one child and one therapist were analyzed for variables that may affect a child's progress, such as the child's language ability prior to therapy and the therapist's style of interaction and use of various strategies for reaching therapy goals.We found that these variables did not have a strong relationship with therapy outcomes. Variables not analyzed in the current study, such as the strength of the bond between child and therapist, may contribute more to differences in children's progress.We also found that therapists used many different strategies for reaching goals, and some children responded best to particular strategies. However, therapists did not appear to be conscious of these differences across children. Making therapists overtly aware of possible strategies may increase their therapists' to adapt to individual children, thereby increasing therapy effectiveness.iv